CMS finalized a 2.6% hospice payment increase for FY 2026, effective October 1, 2025. On paper, that's good news: roughly $750 million in additional Medicare payments distributed across the hospice industry.
But here's what gets buried in the headline: hospices that don't meet HQRP quality reporting requirements don't get the increase. They get a 1.4% cut instead.
That's a 4% swing. And it's determined entirely by whether your agency submits HOPE assessment data on time.
The FY 2026 Payment Numbers
- Payment rate increase: 2.6%
- Annual hospice cap amount: $35,361.44 (up from $34,465.34 in FY 2025)
- HQRP penalty for non-submission: 4 percentage points, turning the 2.6% increase into a 1.4% reduction
The payment update also varies by location. Rural hospices average 3.0% in FY 2026. Urban hospices average 2.6%. Agencies in New England are seeing the highest increases (3.9%); Pacific region hospices the lowest (1.5%).
The HQRP Connection You Can't Ignore
The Hospice Quality Reporting Program is a 'pay-for-reporting' structure — you're penalized for not submitting data, not for submitting poor data. The act of submitting HOPE assessments on time is what determines compliance.
HOPE data collected during calendar year 2026 is processed for compliance in 2027. The payment impact hits in FY 2028 (starting October 1, 2027). Miss the 90% timely submission threshold for CY 2026 and you lose the 4-percentage-point annual payment update in FY 2028. Not a warning. An automatic reduction.
The Face-to-Face Attestation Update
Signatures are required. The attestation must include the signature and date of the signing physician or nurse practitioner. CMS restored this requirement after identifying a regulatory gap from the FY 2012 rule.
The attestation no longer needs to be a separate document. It can be a clearly titled section or addendum to the recertification form, or a signed and dated clinical note within the medical record.
The IDG Physician Admission Clarification
CMS clarified that the physician member of the interdisciplinary group may recommend admission to hospice care, aligning the admission regulation with existing certification and CoP requirements.
What This Means for Your Agency
If you're compliant with HQRP and submitting HOPE data on time, FY 2026 is a good year. If you have open questions about your HOPE submission status, iQIES configuration, or timeliness compliance threshold, those are problems to solve now, not in 2027 when the payment impact becomes visible.
WorldView's documentation and workflow tools help hospice agencies maintain audit-ready records, track physician order signatures, and stay on top of HOPE documentation requirements before submission deadlines. Schedule a demo to see how agencies use it to protect their payment rates.
